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目的探讨基线拥有不同代谢综合征(MS,包括高血压、超重或肥胖、高脂血症和高血糖4个组分)组分个数的人群血清谷丙转氨酶(ALT)与MS的关系。方法基于东营市某三甲医院纵向体检资料构建2006年1月至2011年12月动态体检队列,选取未患M S且至少有3次完整体检资料的5 122名调查对象纳入基线,并根据研究对象拥有MS组分个数的不同(0~2个)进行分层,建立多因素广义估计方程模型(GEE),分析ALT(四分位数间距)与MS发生的相关性,计算RR值及95%CI。结果血清ALT水平的升高与MS及其组分的发生呈正相关。与ALT最低水平组相比,基线有0~2个MS组分的人群ALT最高水平组与MS发生的RR值依次为4.39(2.26~8.52)、6.97(3.37~14.42)和1.93(1.26~2.95),基线0个MS组分和仅有1个MS组分的研究对象高水平血清ALT对MS发生的预测性高于基线有2个MS组分的研究对象。结论高水平ALT对MS的发生有一定预测性,并在代谢状况不同的人群中有不同表现,血清ALT水平的升高可能是MS发生的早期标志物。
Objective To investigate the relationship between serum alanine aminotransferase (ALT) and MS in patients with baseline metabolic syndrome (MS, including hypertension, overweight or obesity, hyperlipidemia and hyperglycemia). Methods Based on longitudinal physical examination information of a top three hospital in Dongying City, a dynamic physical examination cohort from January 2006 to December 2011 was constructed. 5 122 survey subjects who did not have MS and had at least 3 complete physical examination data were included in the baseline and were included according to the subjects (0 ~ 2) stratified by the number of MS components to establish a multi-factor generalized estimating equation model (GEE), analyze the correlation between ALT (quartile spacing) and occurrence of MS, calculate the RR value and 95% CI. Results Serum ALT levels were positively correlated with the occurrence of MS and its components. Compared with the ALT lowest level group, RR of the highest level of ALT and MS in the population with 0-2 MS groups were 4.39 (2.26-8.52), 6.97 (3.37-14.42) and 1.93 (1.26-2.95) ), Subjects with baseline 0 MS and only 1 MS at a high level of serum ALT were more predictive of MS than those with 2 MS at baseline. Conclusions High levels of ALT may predict the occurrence of MS and may show different manifestations in people with different metabolic status. Elevated serum ALT level may be an early marker of MS.